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What is the reaction of the Smallpox vaccination and what care should be taken?
The Smallpox vaccination once given usually shows a reddish reaction on the third day which becomes a vesicle on the 5th and pustule on the 7th day. This lasts for 48—72 hours, when the pustule bursts discharging its contents and leaving an ulcer which usually crusts up by the 14th day and heals by leaving a scar at the end of 3 weeks. High temperature may be there on the 8th and 9th day with a lot of redness on the vaccinated site. It is necessary to keep the temperature down (with paracetamol or aspirin). As regards the care of the vaccinated site, it is necessary to' realise that nothing should be applied on it. No powder or medicines need be applied. If necessary, spirit may be applied two to three times a day. When the vaccinated site is discharging, it is very necessary that clean cotton is used for cleaning it.
What is the course of the BCG vaccination?
BCG is done on the left arm, high up. The mark caused by the injection usually disappears and for two to three weeks there may be no reaction on the site. After about three weeks a small vesicle appears at the site of injection, this becomes opaque and later a discharging ulcer. In the course of 2—3 weeks the whole thing clears up leaving a -scar at the site.
During this process the regional lymph-nodes in the axilla always enlarge, sibsiding on their own. In some infants they may take longer.
What are the untoward manifestations of BCG?
The ulcer on the arm may continue discharging for some time but usually heals by 12 weeks. In any case no medicines should be given before this period.
The regional lymph-nodes may enlarge and not regress. Again unless they soften up or become an abscess they should not be touched. If a discharging sinus forms, it needs surgical and medical treatment, so ask your doctor for advice.
Can BCG cause tuberculosis?
No, not in common terminology. I say this because by introducing the germs which are attenuated, one hopes to cause a small primary complex at the skin level, so that immunity is developed. But it does not cause tuberculosis as we understand it. If a child has had the infection earlier then the reaction to BCG inoculation will be very marked which should draw the attention of the treating physician for further investigations and treatment.
What is meant by the term vesicle and pustule?
The term vesicle means small blister filled with clear fluid and pustule means blister with opaque material.
Is it essential to repeat the Smallpox vaccine, if it does not errupt the first time and at what age should we repeat triple antigen vaccine?
If there is no effect of the Smallpox vaccination, i.e. no successful scar, it should be repeated every six weeks till it is positive, and later every three years. Triple Antigen must be repeated at 1 year after the last injection and then at 5 years and later it should not be DPT but DT only, every three years, till the child is 15 years of age. We do not like to give DPT after six years of age. since pertussis vaccine may be dangerous.